Seek medical attention right away if any of these SEVERE side effects occur while taking miconazole:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); burning, pain, or swelling at the application site; sores on the mouth or tongue; unusual tiredness or weakness.

For Healthcare Professionals

Applies to miconazole: buccal tablet, intravenous solution

General

The overall safety of miconazole buccal tablets was assessed in 480 adult subjects, including 315 HIV-infected subjects, 147 subjects with head and neck cancer, and 18 healthy subjects. Discontinuation due to side effects occurred in 0.6% of subjects overall.

Although intravenous miconazole has been discontinued in the U.S., side effects associated with this formulation have been included.[Ref]

Respiratory

Hematologic

Hematologic side effects have included anemia (2.8%), lymphopenia (1.7%), and neutropenia (0.7%). Transient decreases in hematocrit, thrombocytosis, thrombocytopenia, and erythrocyte aggregation have been reported with intravenous miconazole.[Ref]

Other

Other side effects have included fatigue (2.8%) and pain (1%). Fever and chills have been reported with intravenous miconazole.[Ref]

Dermatologic

Dermatologic side effects have included pruritus (2%). Pruritus (which may have been accompanied by maculopapular rash) has been reported with intravenous miconazole, and in some cases, severe pruritus developed after weeks of therapy or after therapy was completed.[Ref]

Hepatic

Hepatic side effects have included elevated gamma glutamyltransferase (1%).[Ref]

Hypersensitivity

Hypersensitivity side effects have included allergic reaction (including anaphylactic reactions and hypersensitivity). Contact dermatitis has been reported when intravenous miconazole was used topically. Anaphylaxis has been reported rarely with intravenous miconazole.[Ref]

Metabolic

Increases in cholesterol and triglycerides reported in patients receiving intravenous miconazole were due to its vehicle, and were reversible upon discontinuation of the drug. Hyperlipidemia due to Cremophor EL had the atypical appearance of gamma-2 globulin.

Hyponatremia associated with intravenous miconazole therapy resulted in a mean decrease in sodium of 10 mEq/L, but usually was not a reason to discontinue therapy. Miconazole was usually administered in normal saline solution to help minimize decreases in sodium.[Ref]

Metabolic side effects associated with intravenous miconazole have included hyperlipidemia, which was associated with the vehicle of miconazole (Cremophor EL [polyethoxylated castor oil]), and hyponatremia.[Ref]

Cardiovascular

Cardiovascular side effects associated with intravenous miconazole have included cardiac arrhythmias, tachycardia, and cardiac arrest. These effects may have been associated with rapid infusion of miconazole and due to the Cremophor EL vehicle.[Ref]

Ocular

Ocular side effects associated with intravenous miconazole have included blurred vision.

Psychiatric

Psychiatric side effects associated with intravenous miconazole have included euphoria.

Renal

Renal side effects have included acute renal failure, possibly due to intravenous miconazole administration, in one patient with a renal allograft.[Ref]

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